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頁籤選單縮合
題名 | Comparison of Recovery Characteristics of Sevoflurane and Halothane for Outpatient Surgery in Infants=在嬰兒門診手術中比較Sevoflurane和Halothane的恢復特性 |
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作者 | 謝瀛洲; 朱雅淳; 林素滿; 鄒美勇; 蔡勝國; 李德譽; | 書刊名 | 中華醫學雜誌 |
卷期 | 62:11 1999.11[民88.11] |
頁次 | 頁801-806 |
分類號 | 416.53 |
關鍵詞 | 門診手術; 麻醉氣體監視儀; 嬰兒麻醉; Ambultory surgery; Mass spectrometry; Pediatric anesthesia; Sevoflurane; |
語文 | 英文(English) |
中文摘要 | 背景:Sevoflurane乃是臺灣最近核准上市的新一代吸入性麻醉劑。國外已證實,其在成人和小孩中使用均有較快速之麻醉恢復;但是,嬰兒卻因溝通上的困難,而無法準確評估其恢復速率。本研究旨在運用麻醉氣體監視儀,在嬰兒門診手術中比較Sevoflurane 和halothane的催醒恢復特性,並評估此儀器使用之可行性。 方法:40位麻醉危險評估等級為第Ⅰ級,且預備接受門診泌尿科手術的嬰兒被選入本研究。他們被隨機分為2組,每組有20位嬰兒,各自選用sevoflurane或halothane作為手術中的吸入性麻醉劑。當手術結束便關掉麻醉劑,接�撓g由麻醉氣體監視儀記錄自關掉麻醉劑起到拔除氣管內管期間,每分鐘吐氣末端測得的sevoflurane或halothane濃度。取前10分鐘的記錄,繪製出這2種藥劑的衰退曲線,並記錄自關掉麻醉劑到病嬰自發性活動和拔除氣管內管之時間。麻醉催醒時之不良反應亦一併記錄。 結果:經由2種藥劑的衰退曲線,獲得sevoflurane之排除時間常數為1.43秒,halothane為2.59秒。halothane比較,sevoflurane為較快排除之吸入性麻醉劑。接受sevoflurane麻醉的嬰兒,拔管時間較早,且有較高比例的麻醉後哭鬧燥動情況發生,但未具統計學意義。 結論:在嬰兒門診手術麻醉中,經由麻醉氣體監視儀記錄吐氣末端濃度而得到之藥劑排除顯示,sevoflurane的排除比halothane要快,且無明顯的手術後副作用。 |
英文摘要 | Background: Sevoflurane, a newly approved potent inhaled anesthetic in Taiwan, provides rapid emergence from anesthesia in adults and children. Clinically, it is difficult to accurately assess the rate of recovery from anesthesia in infants. This study was designed to compare the emergence characteristics of halothane with those of sevoflurane having recourse to a respiratory agent monitor in infants undergoing outpatient surgery. Methods: Forty infants of ASA class I, scheduled for day-case urologica surgery were studied. Patients were randomly allocated to two groups of 20. Sevoflurane or halothane was used as the inhaled anesthetic. Toward the end of surgery sevoflurane or halothane was turned off. The concentrations of exhaled sevoflurane or halothane were read every minute after its discontinuation until extubation. The decay curve of the exhaled concentration of either agent was recorded minute by minute for 10 minutes. The time intervals from discontinuation of the inhalation agent to spontaneous movement and tracheal extubation were recorded. Untoward side-effects during emergence were also compared. Results: Sevoflurance was eliminated faster than halothane. Based on the decay curves of the exhaled concentrations of the two agents, the time constant for halothane was 2.59 minutes and that for sevoflurane was only 1.43 minutes. The time from discontinuation of agent to extubation was also shorter for sevoflurane. Postoperative restlessness or agitation occurred more frequently in infants who received sevoflurane, although the difference was of no statistical significance. Conclusion: Sevoflurane is superior to halothane for rapid elimination in infant outpatient surgery as gauged by observation of end-tidal concentration elimination curves recorded with a respiratory agent monitor. No other postoperative side-effect was evident in sevoflurane anesthesia. |
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